| 髓外多发性骨髓瘤的免疫学特征及其意义 |
| 投稿时间：2025-02-26 修订日期：2025-03-12 点此下载全文 |
| 引用本文：李晓莎,彭晓欢,张连生,李莉娟.髓外多发性骨髓瘤的免疫学特征及其意义[J].医学研究杂志,2025,54(8):63-67 |
| DOI：
10.11969/j.issn.1673-548X.2025.08.011 |
| 摘要点击次数: 13 |
| 全文下载次数: 7 |
|
| 基金项目:国家自然科学基金资助项目(8236010019)；甘肃省自然科学基金资助项目(21JR7RA435,21JR7RA394) |
|
| 中文摘要:目的 研究髓外多发性骨髓瘤(extramedullary multiple myeloma, EMM)患者是否存在免疫学及血液学指标差异。方法 回顾性分析2019年1月～2024年1月兰州大学第二医院血液内科收治的150例新诊断的多发性骨髓瘤(multiple myeloma, MM)患者的病例资料,比较并分析EMM组(n=60)和非EMM组(n=90)及不同危险分层DS分期、Mayo骨髓瘤危险分层两个亚组的免疫学指标和部分血液学指标差异。结果 EMM组患者外周血红细胞计数、血红蛋白水平、乳酸脱氢酶(lactic acid dehydrogenase, LDH)水平以及白细胞介素-8(interleukins-8, IL-8)水平均较非EMM组升高(P<0.05),EMM组IL-10(interleukins-10, IL-10)、CD4+T细胞比例较非EMM组降低(P<0.05)。标危MM患者中EMM组淋巴细胞计数显著升高(P<0.05),CD8+T细胞比例显著降低(P<0.05)。高危MM患者中EMM组外周血CD8+T细胞比例较非EMM组明显降低(P<0.05)。DS-Ⅰ期和DS-Ⅱ期MM患者中,EMM组LDH水平较非EMM组高(P<0.05)。DS-Ⅲ期MM患者中,EMM组外周血红细胞计数、单核细胞计数及血红蛋白水平均较非EMM组升高(P<0.05)。结论 免疫异常可能是EMM发生、发展及预后较差的因素之一,研究提示CD8+T细胞作为免疫效应细胞,可进一步研究其在MM发生、进展至EMM变化,为临床治疗提供新依据。 |
| 中文关键词:多发性骨髓瘤 髓外病变 免疫 临床特征 |
| |
| Immunologic Features and Significance of Extramedullary Multiple Myeloma. |
|
|
| Abstract:Objective To study whether there are differences in immunological and hematological indexes in patients with extramedullary multiple myeloma (EMM). Methods The medical records of 150 newly diagnosed multiple myeloma (MM) patients admitted to Department of Hematology, the Second Hospital of Lanzhou University from January 2019 to January 2024 were retrospectively analyzed, to compare and analyze the differences in immunological and some hematological indexes between the EMM group (n=60) and the non-EMM group (n=90), and the two subgroups of the different risk stratification DS stages and Mayo myeloma risk stratification. ResultsThe peripheral blood erythrocyte count, hemoglobin level, lactic acid dehydrogenase (LDH) level and interleukins-8 (IL-8) levels of the patients in the EMM group were higher than those in the non-EMM group (P<0.05), the interleukins-10 (IL-10) and the proportion of CD4+ T cells in the EMM group were lower than those in the non-EMM group (P<0.05). Lymphocyte counts were significantly higher (P<0.05) and the proportion of CD8+T cells was significantly lower (P<0.05) in the EMM group of patients with standard-risk MM. The proportion of peripheral blood CD8+T cells was significantly lower in the EMM group compared with the non-EMM group of patients with high-risk MM (P<0.05). LDH levels were higher in the EMM group than that in the non-EMM group in both DS-Ⅰ and DS-Ⅱ MM patients (P<0.05). Peripheral blood erythrocyte count, monocyte count, and hemoglobin level were higher in the EMM group than those in the non-EMM group in DS-III MM patients (P<0.05). Conclusion Immune abnormalities may be one of the factors contributing to the occurrence, development and poor prognosis of EMM. This study suggest that CD8+T cells, as immune effector cells, can be further studied in the occurrence and progression of MM to EMM, providing a new basis for clinical treatment. |
| keywords:Multiple myeloma Extramedullary lesions Immunological Clinical features |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
